title: Postpartum voiding dysfunction: identifying the risk factors.
abstract: BACKGROUND
  Postpartum urinary retention (PPUR) (also known as voiding dysfunction) is a common problem, defined as the inability to completely void after giving birth. If voiding dysfunction is not recognised, bladder overdistension can lead to denervation, detrusor atony and prolonged voiding dysfunction.
  
  
  OBJECTIVE
  To describe the incidence of PPUR amongst postpartum women undergoing routine bladder scanning and to identify the factors that lead to postpartum voiding dysfunction.
  
  
  METHODS
  A retrospective analysis of all postpartum women at Mater Health Services, Brisbane between February and December 2012 was undertaken. Routinely collected postvoid residual bladder volumes (PVRBV) were reported using a bladder scanner at four and six hours and two to three days postbirth or following removal of an indwelling catheter (IDC). The characteristics of women with or without increased PVRBV were analysed.
  
  
  RESULTS
  Postvoid residual bladder volumes at four-hours postbirth/removal of IDC were available for 5558 women of whom 281 (5.1%) had a residual volume measured >150 mL. Obstetric factors explored included mode of birth, method of analgesia or anaesthesia, duration of labour, degree of perineal trauma, birth weight, gestation, parity, maternal age and body mass index. After controlling for confounders, nulliparity (aOR 1.53; 95% CI 1.05-2.26), birth by caesarean section (aOR 2.21; 95% CI 1.10-4.41) and 3rd/4th degree perineal trauma (aOR 2.01; 95% CI 1.09-3.72) were significant independent predictors of PPUR.
  
  
  CONCLUSIONS
  Following the introduction of a protocol of timed voiding and routine measurement of PVRBV after birth/removal of IDC, PPUR is uncommon. Adopting a risk-factor-based approach to PVRBV screening is not supported by these data.
authors.affiliation: Department of Obstetrics and Gynaecology, Mater Health Services, South Brisbane, Queensland, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Buchanan
authors.forename: Michael
authors.initials: M
authors.lastname: Beckmann
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007743:Labor, Obstetric; D009929:Organ Size; D049590:Postpartum Period; D011247:Pregnancy; D011644:Puerperal Disorders / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D001743:Urinary Bladder / Q000033:anatomy & histology; D016055:Urinary Retention / Q000453:epidemiology / Q000209:etiology*; D014556:Urine
keywords: postpartum; risk factors; voiding dysfunction